Seeking Assistance: Persistent Rash Since June
I have a seven-year-old daughter who has been experiencing an unresolved rash since June. Thankfully, she has no additional health complications. The rash initially appeared in her groin area and on her buttocks and has since spread to her inner thighs, butt cheeks, back of her knees, armpits, and the bends of her elbows. We've conducted several tests, including blood samples, all of which returned normal results. Both bacterial and fungal cultures indicated no signs of infection. We’ve consulted with a total of six pediatricians and two dermatologists, but no one has been able to provide a diagnosis. We’ve attempted various treatments, including mupirocin, clotrimazole, fluconazole, hydrocortisone, and triamcinolone. Among these, only triamcinolone has offered any relief, but as soon as we discontinue usage, the rash reappears. It seems to aggravate with heat, sweating, and also when she swims. I am reaching out for advice. A source suggested it could be flexural eczema; however, the dermatologist disagreed, stating it doesn't resemble eczema. Moving forward, our next step will be a referral to a rheumatologist, as advised by her pediatrician. Any insights or suggestions would be greatly appreciated!
Answers (1)
8/13/2025, 2:41:12 AM
OpenHealth AI
It sounds like your daughter is having a frustrating and uncomfortable experience with this persistent rash. The main points to consider are the possible causes of her rash, the treatments attempted, and the factors that seem to worsen her condition.
Explanation:
Since her rash has persisted despite numerous tests and treatments, it’s essential to focus on the patterns and potential triggers you've noticed. The fact that it worsens with heat and sweating suggests that it might be related to friction or irritation, which aligns with flexural dermatitis or irritation rather than an infection.
Chronic rashes in children can often be linked to conditions like eczema, allergic reactions, or inflammatory skin conditions. Given that she's experienced some relief with triamcinolone, it indicates an inflammatory component that might respond to topical corticosteroids. However, persistent use may lead to side effects or rebound rashes when the medication is stopped.
Next Steps:
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Continue Observation: Keep a detailed diary of her rash, noting any changes with activities, environmental conditions (like swimming), or after trying specific products (soaps, laundry detergents, etc.).
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Skin Care Routine: Establish a gentle skin care regimen:
- Use mild, fragrance-free soap and moisturizers regularly to keep her skin hydrated.
- Limit long hot baths or showers, as they may dry out the skin.
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Manage Triggers: Since you noted that heat, sweating, and swimming seem to provoke the rash, consider:
- Keeping her cool and wearing loose-fitting, breathable clothing.
- Using a barrier cream (like a zinc oxide or petroleum jelly) on areas that might experience friction or moisture.
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Follow Up on Referral: The referral to a rheumatologist is a prudent step, as they can evaluate for systemic conditions that might contribute to skin symptoms, especially if there are any associated joint or systemic symptoms.
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Reassess Topical Treatments: Since triamcinolone provided some relief, discussing a potential recalibration of your treatment plan with the dermatologist—maybe a rotation of topical corticosteroids or combining with emollients—might be beneficial.
Your daughter's comfort and quality of life are paramount, and continuing to explore options while monitoring her skin condition closely will help in managing and potentially alleviating the rash. Please let me know if you need additional information or specific guidance!
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - 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